Midwife-led units threatened

10th March 2011

Midwife-led maternity centres are under threat from cost cuts and falling deliveries.

The new standalone midwife-led centres have been proposed in several reconfigurations in which consultant-led services are being centralised, including Maidstone, Sandwell, Salford and north east London.

However, findings from HSJ claim that existing midwife-led units are often underused and some appear to be unsustainable.

Figures show that 17 out 32 standalone centres have seen falling births.

Reasons for the fall have been reluctance of GPs to refer or of mothers to use them, poor marketing and temporary closures.

The future of units at Cottingham Hospital near Hull and Andover in Hampshire, where births are currently suspended, is under question and services across East Kent and in Derbyshire are being reviewed.

NHS Derbyshire County said it is looking at all areas of spending, which includes its Darley Dale birth centre.

However, the Royal College of Midwives has urged trust to support the units and explore options to save them such as locating them within other NHS units.

There is no agreed level at which a midwife-led unit is viable, but the RCM acknowledges that units with fewer than 300 births a year are unlikely to break even.

RCM policy director Sean O’Sullivan said: “If you have a unit which has more than 300 births a year then there is a strong case for its retention.”

Health secretary Andrew Lansley has said the evidence for standalone midwife-led units would need to be looked at before any decision was made.